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Doctor-patient communication is pivotal for the delivery of effective health care, patient satisfaction and retention, and the development of patient loyalty to the provider. However, the interactional dynamics of loyalty in real-life communication are left underexplored. In this regard, this study aims to examine and analyze loyalty in naturally occurring routine chronic encounters. Based on audio-recordings collected in a state-run tier-three hospital in China, the study uses conversation analysis to examine the sequential placement of loyalty display and its interactional functions in different environments. The findings report two sequential environments where loyalty display emerges: the opening and closing phases. The findings also show that loyalty is mainly produced by the patient to display affiliation and commitment, indicate their preferred treatment options, and rekindle a disconnected relationship. This work contributes to a more nuanced understanding of loyalty display in service and institutional encounters. • Patient loyalty often occurs in medical openings and closings. • It displays affiliation and commitment. • It may suggest a particular treatment. • It may be provided to repair a relationship. [ABSTRACT FROM AUTHOR]

China's large-scale high-speed rail (HSR) construction has raised heated debates worldwide. Differing from previous research on metropolitan areas, this study examines on the economic impacts on periphery cities connected by HSR lines. Using a unique panel dataset of 237 Chinese non-core cities at the prefecture level spanning from 2002 to 2016, this study adopts a spatial difference-in-differences model to investigate the impact of HSR on service industry output. The estimation results suggest that the operation of HSR has a significant negative impact on service industry output of non-core cities, confirming the existence of a siphoning effect of HSR. Such negative impact varies with the profile of the non-core cities. HSR-connected non-core cities in the relatively well-developed coastal region, medium-sized and located within half-an-hour's travel time to mega cities tended to be associated with the most pronounced reductions. These findings provide important implications to the Chinese government and could be cogent for those planning or constructing HSR lines in other countries, given the numerous ongoing HSR initiatives around the globe. • This study adopts a spatial DID model to investigate the economic impact of HSR in connected non-core cities. • Non-core HSR cities exhibit lower service industry output due to the siphoning effect induced by HSR. • Non-core cities located in the better-developed coastal regions experience more service industry losses compared to the interiors. • The medium-sized non-core cities suffer more losses than both the large-sized and small-sized cities. • The non-core cities close to the core cities experience more reductions compared to the faraway. [ABSTRACT FROM AUTHOR]

Background: CPGs are not uniformly successful in improving care and several instances of implementation failure have been reported. Performing a comprehensive assessment of the barriers and enablers is key to developing an informed implementation strategy. Our objective was to investigate determinants of guideline implementation and explore associations of self-reported adherence to guidelines with characteristics of participants in China.Methods: This is a cross-sectional survey, using multi-stage stratified typical sampling based on China's economic regional divisions (the East, the Middle, the West and the Northeast). 2-5 provinces were selected from each region. 2-3 cities were selected in each province, and secondary and tertiary hospitals from each city were included. We developed a questionnaire underpinned by recommended methods for the design and conduct of self-administered surveys and based on conceptual framework of guideline use, in-depth related literature analysis, guideline development manuals, related behavior change theory. Finally, multivariate analyses were performed using logistic regression to produce adjusted odds ratios (OR) and 95% confidence intervals (95% CI).Results: The questionnaire consisted of four sections: knowledge of methodology for developing guidelines; barriers to accessing guideline; barriers to guideline implementation; and methods for improving guideline implementation. There were 1732 participants (87.3% response rate) from 51 hospitals. Of these, 77.2% reported to have used guidelines frequently or very frequently. The key barriers to guideline use were lack of education or training (46.2%), and overly simplistic wording or overly broad scope of recommendations (43.8%). Level of adherence to guidelines was associated with geographical regions (the northeast P < 0.001; the west P = 0.02; the middle P < 0.001 compared with the east), hospital grades (P = 0.028), length of practitioners' practice (P = 0.006), education background (Ph.D., P = 0.027; Master, P = 0.002), evidence-based medicine skills acquired in work unit (P = 0.012), and medical specialty of practitioner (General Practice, P = 0.006; Surgery, P = 0.043).Conclusion: Despite general acknowledgement of the importance of guidelines, the use of guidelines was not as frequent as might have been expected. To optimize the likelihood of adherence to guidelines, guideline implementation should follow an actively developed dissemination plan incorporating features associated with adherence in our study. [ABSTRACT FROM AUTHOR]

Objective: The association between a (GT)n dinucleotide length polymorphism in the promoter region of heme oxygenase 1 (HMOX1) and the risk of neonatal hyperbilirubinemia remains controversial. This meta-analysis was, therefore, performed with aims to examine the correlation between the HMOX1 (GT)n repeat length polymorphism and neonatal hyperbilirubinemia susceptibility.Materials and methods: We searched the databases including PubMed, Embase, Cochrane Library, China national knowledge infrastructure (CNKI), and Wanfang Data, with all reviewed studies published before 28 June 2018. After the evaluation of quality, we used RevMan to perform the meta-analyses. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the effect of HMOX1 gene promoter polymorphisms on the risk of neonatal hyperbilirubinemia.Results: Seven studies, involving 584 patients with neonatal hyperbilirubinemia and 1655 controls, were included. A statistically significant association was found between the HMOX1 (GT)n repeat length polymorphism and risk of neonatal hyperbilirubinemia under the allele (allele S vs. allele L: OR = 1.81, 95% CI = 1.22-2.67, p = .003), recessive (genotype SS vs. genotypes LS + LL: OR = 1.38, 95% CI = 1.02-1.86, p = .04), dominant (genotypes SS + LS vs. LL: OR = 1.37, 95% CI = 1.01-1.76, p = .01), and homozygous genetic models (genotype SS vs. genotype LL: OR = 1.47, 95% CI = 1.02-2.11, p = .003), but not under the heterozygous genetic model. Interestingly, subgroup analysis revealed that the cutoffs of the S allele < 25 showed significant associations in any of the five genetic models (allele S vs. allele L: OR = 2.26, 95% CI = 1.68-3.05, p < .00001; genotype SS vs. genotypes LS + LL: OR = 2.56, 95% CI = 1.41-4.65, p = .002; genotypes SS + LS vs. genotype LL: OR = 1.82, 95% CI = 1.28-2.59, p = .0009; genotype SS vs. genotype LL: OR = 3.09, 95% CI = 1.50-6.36, p = .002; genotype LS vs. genotype LL: OR = 1.64, 95% CI = 1.11-2.42, p = .01); however, this association was not observed in the cutoffs of the S allele ≥25.Conclusion: The results of this study indicate that there is a significant association between the HMOX1 (GT)n repeat length polymorphism and susceptibility to neonatal hyperbilirubinemia. Newborns carrying shorter (GT)n repeats in the HMOX1 gene promoter may have a higher risk of neonatal hyperbilirubinemia. [ABSTRACT FROM AUTHOR]

Aims and objectives: To compare the differences in psychosocial behaviour reactions, psychosocial needs, anxiety and depression before and after colostomy surgery and to explore the predictors of psychosocial behaviour reactions. Background: Colorectal cancer is increasing worldwide. Abdominoperineal resection accompanied by permanent colostomy can cause complicated psychosocial reactions and needs. However, colostomy patients' trajectories of psychosocial adjustment at different time points must be discussed. Design: A longitudinal study. Methods: Using a convenience sampling method, 67 patients planning to undergo colostomy surgery were recruited from a tertiary cancer centre in southern China from January 2013–January 2014. Data collection consisted of two phases, conducted 1–2 days before surgery and 1–2 days prior to discharge. The Ostomy Psychosocial Behaviour Reaction Questionnaire, the Ostomy Psychosocial Needs Questionnaire, the Hospital Anxiety and Depression Scale and a self‐designed demographic questionnaire were used to collect data. STROBE guidelines were followed. Results: The participants had a moderate level of psychosocial behaviour reactions, a deep and wide range of psychosocial needs and a high incidence of anxiety and depression before and after surgery. Anxiety before surgery was significantly higher than that after surgery. Psychosocial needs and anxiety were significant predictors of psychosocial behaviour reactions. Conclusions: Patients' anxiety was alleviated after surgery. The combination of ascertaining and meeting various psychosocial needs and managing negative emotions was helpful in alleviating patients' stress responses before and after surgery. Relevance to clinical practice: An increased focus on the relationships among psychosocial behaviour reactions, psychosocial needs, anxiety and depression at different time points in colostomy patients is necessary for future research and practice. [ABSTRACT FROM AUTHOR]

Crizotinib is an anti‑cancer drug with a substantial beneficial effect in advanced non‑small‑cell lung cancer (NSCLC) patients harboring anaplastic lymphoma kinase (ALK) rearrangement. However, the real‑world data currently available on this drug are limited. Thus, the present study aimed to retrospectively examine the treatment patterns and survival outcome of 83 advanced NSCLC patients with ALK rearrangement in a single center in China. Of the 83 patients enrolled, 33 (39.8%) patients received crizotinib and the remaining 50 (60.2%) patients received chemotherapy as the initial therapy. The first‑line use of crizotinib prolonged the PFS1 (progression‑free survival to the first detection of subsequent disease progression) compared with chemotherapy (median, 18.5 vs. 4.9 months; P<0.001), however, it did not prolong the overall survival (OS; P=0.802). At the last follow up, 71 (85.5%) patients had received crizotinib and 12 (14.5%) patients were crizotinib‑naive. Patients who had received crizotinib exhibited a significantly longer OS as compared with those who were crizotinib‑naive [hazard ratio (HR) for mortality, 0.279; 95% confidence interval, 0.107‑0.727; P<0.05). Among the 71 patients who had received crizotinib, this was administered as a first‑line therapy in 33 (46.5%) cases, as a second‑line therapy in 22 (31.0%) cases and after the second‑line therapy in 16 (22.5%) cases. No significant difference in the OS among the three groups was observed (P=0.577). The Cox multivariate analysis identified the following independent negative prognostic factors for OS: Smoking history (HR=4.565), liver invasion at diagnosis (HR=4.294) and bone invasion at diagnosis (HR=2.587). In addition, the use of crizotinib (HR=0.319) was identified as a positive prognostic factor for OS. In conclusion, the present real‑world study revealed that the use of crizotinib improved the long‑term survival of patients with ALK‑positive advanced NSCLC. There was no difference in survival outcome between patients with initial use of crizotinib and those with subsequent use of crizotinib after first‑line therapy. [ABSTRACT FROM AUTHOR]

Aims and objectives: To reveal nurses’ self‐reported practice of managing chest tubes and to define decision‐makers for these practices. Background: No consensus exists regarding ideal chest‐tube management strategy, and there are wide variations of practice based on local policies and individual preferences, rather than standardised evidence‐based protocols. Design: This article describes a cross‐sectional study. Methods: Questionnaires were emailed to 31 hospitals in Tianjin, and the sample consisted of 296 clinical nurses whose work included nursing management of chest drains. The questionnaire, which was prepared by the authors of this research, consisted of three sections, including a total of 22 questions that asked for demographic information, answers regarding nursing management that reflected the practice they actually performed and who the decision‐makers were regarding eight chest‐drain management procedures. McNemar's test was used to analyse the data. Results: The results indicated that most respondents thought that it was necessary to manipulate chest tubes to remove clots impeding unobstructed drainage (91.2%). Most respondents indicated that dressings would be changed when the dressing was dysfunctional. At the same time, more than half of respondents approved of changing dressings routinely, and the frequency of changing dressings varied. When drainage was employed for pleural effusion and for a pneumothorax, 64.6% and 94.5% of respondents, respectively, considered that underwater seal‐drainage bottles should be changed routinely, and the frequency of changing bottles both varied. The results indicated that nurses were the primary decision‐makers in the replacement of chest tubes, manipulation of chest tubes and monitoring of drainage fluid. Conclusions: There was considerable variation in respondents’ self‐reported clinical nursing practice regarding management of chest drains. The rationale on which respondents’ practices were based also varied greatly. This study indicated that nurses were the primary decision‐makers for three of eight procedures regarding management of chest drains, which reflects that clinical nurses’ decision‐making power regarding management of chest drains was weak. Relevance to clinical practice: This study describes the nurse‐reported practices of Chinese nurses from Tianjin, including changing and selecting dressing types, manipulating chest tubes, clamping drains and replacing drainage bottles, and the study defines who the decision‐makers were for these interventions. By focusing on nurses’ self‐report of behaviours in managing chest drains (actual nursing practice vs. nursing knowledge), this article also relates the literature to the research findings and denotes the gaps in knowledge for future research. [ABSTRACT FROM AUTHOR]

Gestational diabetes mellitus affects millions of pregnant women. Lifestyle intervention is recommended as the first-line treatment, in which exercise plays an important role. Effective and safe exercise is required to facilitate glycaemic control and improve delivery outcomes. To investigate the efficacy and safety of the original Gymnastics for Pregnant Women program for glycaemic control and delivery outcomes improvement in gestational diabetes mellitus women. The study was a two-arm parallel randomized controlled clinical trial. The study was conducted in a tertiary specialized maternity hospital in Hangzhou, China. Totally 131 eligible pregnant women were enrolled from June to December 2020. Participants were randomly allocated to the control group (conventional intervention) or experimental group that engaged in the original Gymnastics for Pregnant Women program. The primary outcomes included glycaemic control during pregnancy and postpartum. Secondary outcomes included adverse events, maternal and neonatal outcomes. Participants showed a significant improvement in glycaemic control after engaging in the intervention for 2 weeks; the improvement was most significant in terms of the 2-h postprandial plasma glucose (P < 0.05). The fasting blood glucose and 2-h postprandial plasma glucose data indicated a higher glycaemic control rate in the experimental than control group (86.16% vs. 66.67%, P = 0.008; and 84.62% vs. 36.36% [6.09 ± 0.79 vs. 6.96 ± 1.06 mmol/L], P < 0.001, respectively). After delivery, the 2-h oral glucose tolerance test results indicated better glycaemic control in the experimental than control group (75.44% vs. 57.41% [6.93 ± 1.44 vs. 7.79 ± 2.03 mmol/L], P = 0.047). Additionally, the 2-h oral glucose tolerance test in the experimental group with reasonable exercise frequency (≥ 10 times per week) had the best glucose level (6.81 ± 1.30 mmol/L), followed by the experimental group with a lower exercise frequency (< 10 times per week) (7.35 ± 1.83 mmol/L) and the control group (7.79 ± 2.03 mmol/L). No statistical differences in maternal or neonatal outcomes were observed between the control and experimental groups (P > 0.05). In addition, there were no adverse events in the experimental group; however, in the control group, two cases experienced at least one hypoglycaemic episode and two cases received insulin during the study period. The original Gymnastics for Pregnant Women was associated with greater improvements in blood glucose levels during pregnancy and postpartum compared with a conventional intervention for women with gestational diabetes mellitus. ChiCTR2000033963 (2020-06-22). The original Gymnastics for Pregnant Women program improves glycaemic control in GDM women but does not affect delivery outcomes. [ABSTRACT FROM AUTHOR]

Spines or trichomes on the fruit of cucumbers enhance their commercial value in China. In addition, glabrous mutants exhibit resistance to aphids and therefore their use by growers can reduce pesticide residues. Previous studies have reported two glabrous mutant plants containing the genes, csgl1 and csgl2. In the present study, a new glabrous mutant, NCG157, was identified showing a gene interaction effect with csgl1 and csgl2. This mutant showed the glabrous character on stems, leaves, tendrils, receptacles and ovaries, and there were no spines or tumors on the fruit surface. Inheritance analysis showed that a single recessive gene, named csgl3, determined the glabrous trait. An F2 population derived from the cross of two inbred lines 9930 (a fresh market type from Northern China that exhibits trichomes) and NCG157 (an American processing type with glabrous surfaces) was used for genetic mapping of the csgl3 gene. By combining bulked segregant analysis (BAS) with molecular markers, 18 markers, including two simple sequence repeats (SSR), nine insertion deletions (InDel) and seven derived cleaved amplified polymorphism sequences (dCAPs), were identified to link to the csgl3 gene. All of the linked markers were used as anchor loci to locate the csgl3 gene on cucumber chromosome 6. The csgl3 gene was mapped between the dCAPs markers dCAPs-21 and dCAPs-19, at genetic distances of 0.05 cM and 0.15 cM, respectively. The physical distance of this region was 19.6 kb. Three markers, InDel-19, dCAPs-2 and dCAPs-11, co-segregated with csgl3. There were two candidate genes in the region, Csa6M514860 and Csa6M514870. Quantitative real-time PCR showed that the expression of Csa6M514870 was higher in the tissues of 9930 than that of NCG157, and this was consistent with their phenotypic characters. Csa6M514870 is therefore postulated to be the candidate gene for the development of trichomes in cucumber. This study will facilitate marker-assisted selection (MAS) of the smooth plant trait in cucumber breeding and provide for future cloning of csgl3. [ABSTRACT FROM AUTHOR]

Objective: To investigate the oncologic and reproductive outcomes after progestin treatment of complex endometrial hyperplasia (CEH) and grade 1 endometrial carcinoma (EC).Methods: In a retrospective study, data were obtained for patients aged 20-42years with CEH or grade 1 EC at presumed stage IA (without myometrial invasion) who wished to preserve fertility and were treated at the Peking Union Medical College Hospital, China, between January 1, 2000, and December 31, 2011. Patients had received oral medroxyprogesterone acetate (250-500mg/day) or megestrol acetate (160-480mg/day) for at least 6months. Response to progestin treatment was assessed histologically.Results: Among 53 included patients, 39 (74%) achieved complete response after a median period of 6 (3-24) months. Complete response was less frequent among obese than nonobese patients (4/12 [33%] vs 35/41 [85%]; P=0.001). Disease recurrence was recorded in 10 (26%) patients with complete response; the 5-year recurrence-free survival rate was 71%. Among the 33 patients who retained a desire to conceive, 17 (52%) became pregnant.Conclusion: Fertility-sparing management with oral progestin is effective. Obesity is associated with a lower probability of long-term success. [ABSTRACT FROM AUTHOR]

The aim of this paper was to evaluate reporting and methodological quality of systematic reviews or meta-analyses in the nursing field in China. Over the last decade, evidence-based nursing has been gradually known and accepted by nurses in China, and the number of systematic reviews or meta-analyses of nursing flied has steadily increased, but the quality of these reviews is unsatisfactory. The Chinese Journal Full-Text Database, the Chinese Biomedicine Literature Database and the Wanfang Database were searched for systematic reviews or meta-analyses in the nursing field, from inception through December 2011. The Preferred Reporting Items of Systematic Reviews and Meta-analyses and the Assessment of Multiple Systematic Reviews checklists were used to assess reporting characteristics and methodological quality, respectively. A total of 63 systematic reviews or meta-analyses were identified. The deficiencies of methodological quality were mainly in literature searches, heterogeneity handling, recognition and assessment of publication bias. In addition, the deficiencies of reporting characteristics were reflected in incomplete reporting of literature search, quality assessment, risk of bias and results. Focusing on improving the quality of reporting and methodological quality of systematic reviews or meta-analyses in the nursing field in China is urgently needed. [ABSTRACT FROM AUTHOR]

The study examines dietary advice-giving in regular consultations for patients with chronic conditions in two types of clinical practices: Traditional Chinese Medicine and Western Medicine practiced in mainland China. Dietary habits are unanimously considered relevant to the patient's health, particularly in chronic conditions. This article reports the differences in where and how dietary advice is occasioned and co-constructed by participants in two settings. One significant finding of this paper is that while Traditional Chinese Medicine doctors take dietary talk to instruct patients and put it into the treatment recommendation, WM doctors may treat it as incidental and only valuable for diagnostic assessment, leaving its treatment opaque and not discussed with the patient. Data are in Mandarin Chinese. Using Conversation Analysis, the article describes the interactional organisation of dietary advice delivery in different medical practices and ascribes their differences to clinical pathology. • Diet as a treatment proposal or not. • Infrequent dietary advice-giving in WM encounters. • Frequent dietary advice-giving in TCM closings. • The organisation of advice reflects clinical understandings of diet. [ABSTRACT FROM AUTHOR]

[Display omitted] • Identification of QSB based on comparing 16S rRNA gene sequences was developed. • QSB in activated sludge primarily belong to rare taxa and conditionally rare taxa. • QSB exhibited higher average clustering coefficient than non-QSB. • QSB keystones and QSB nodes had a positive impact on network complexity. • QSB communities directly contributed to maintaining network robustness. Quorum-sensing bacteria (QSB) are crucial factors for microbial communication, yet their ecological role in wastewater treatment plants (WWTPs) remains unclear. Here, we developed a method to identify QSB by comparing 16S rRNA gene sequences. QSB in 388 activated sludge samples collected from 130 WWTPs across China primarily were identified as rare taxa and conditionally rare taxa. A co-occurrence network shared by all sludge communities revealed that QSB exhibited higher average clustering coefficient (0.46) than non-QSB (0.15). Individual sludge networks demonstrated that quorum sensing microbiomes were positively correlated with network robustness and network complexity, including average clustering coefficient and link density. We confirmed that QSB keystones and QSB nodes have a positive impact on network complexity by influencing network modularity through a structural equation model. Meanwhile, QSB communities directly contributed to maintaining network robustness (r = 0.29, P < 0.05). Hence, QSB play an important role in promoting network complexity and stability. Furthermore, QSB communities were positively associated with the functional composition of activated sludge communities (r = 0.33, P < 0.01), especially the denitrification capacity (r = 0.45, P < 0.001). Overall, we elucidated the ecological significance of QSB and provided support for QS-based regulation of activated sludge microbial communities. [ABSTRACT FROM AUTHOR]

Human metapneumovirus (hMPV) has recently been recognized as an important respiratory pathogen, especially in children. At present, our understanding of the characteristics of hMPV from China is very limited. Nasopharyngeal aspirates were taken from 310 hospitalized pediatric patients. Twenty (6.5%) of them were infected with hMPV, and they all developed pneumonia. Sixty five percent (13/20) of the cases were under 12 months. Phylogenetic analysis of F gene fragments indicated that three sub-genotypes of hMPV(A2a/A2b, B1,B2) circulated in Tianjin and A2b was the predominant subtype. The Vero-E6 cell line was better than LLC-MK2 for hMPV isolation. Three hMPV strains were successfully isolated using the Vero-E6 cell line. [ABSTRACT FROM AUTHOR]

Passenger airline networks are an important agent of social and economic connections between cities, and embody characteristics of complex networks. The study on the survivability of passenger airline networks has positive significance on their healthy and safe development. There have been several in-depth empirical studies on the impact of macrostructural characteristics of complex networks on network survivability, however few studies have focused on the impact of microstructure on network survivability, which is the focus of this paper. As the basic building blocks of the network, colored motifs can distinguish the different functions of nodes or edges in the motif, and then comprehensively depict the network microstructure. We used this characteristic to study the impact of microstructure on network survivability, in this paper. Passenger airline networks of different airlines in China during 2018, were studied, and the three-node and four-node colored motifs of different airline networks were identified. Complex network indexes were used to measure the survivability of airline networks under intentional and random attacks. Multiple linear regression analysis was conducted between the survivability coefficient of each airline network and the concentration of colored motifs to explore the impact of colored motif characteristics on network survivability. The results show that: (1) microscopic topological structures represented by colored motifs in airline networks are closely related to the macro spatial structural modes of airline networks (such as hub and spoke model); (2) vast majority of passenger airline networks in China are more vulnerable to intentional attacks and are robust in the face of random attacks; (3) from the perspective of topological structures of network motifs, motifs with radial and loop structures have positive impacts on network survivability under intentional attacks, while motifs with loop structures had negative impacts on network survivability under random attacks; (4) from the perspective of the type of colored motifs, motifs with a large number of hub nodes, high degree of agglomeration, and strong hub-and-spoke effect can enhance the ability of the network to resist intentional attacks. The agglomeration of non-hub nodes has a positive effect on network survivability under intentional attacks, and a linear structure with hub nodes at both ends can enhance the ability of airline networks to resist random attacks. In actual route planning, adjusting the type of colored motif from the microstructural perspective can be a good means to enhance the survivability of the entire airline network. • It is found that network motifs could affect the passenger airline network survivability. • Colored motifs analysis was employed to reveal the network microstructure. • The effects of different motifs on survivability were tested through scenario simulation. [ABSTRACT FROM AUTHOR]

Outlines some of the major challenges in land use and transportation planning facing the metropolitan area of Beijing, China. Urban planning; Lessons from the experiences of foreign capital cities.

In recent years, China's energy structure has been adjusted unceasingly, where the proportion of natural gas has been increasing year by year, and its external dependence has also been increasing. Therefore, it is necessary to discuss the correlation between China's natural gas market and the international energy market. This paper studies the dynamic relationship between China's total natural gas consumption, consumption structure, and the international price of oil from the perspectives of mutation and time-variance, using the cointegration test with regime shifts and a state space model. The results show that during the global financial crisis in 2008, the cointegration relationship between China's total natural gas consumption and the international oil price has undergone structural changes. January 2012 and March 2015 are potential structural mutation points. After the structural mutation, the impact of the international price of oil on China's total natural gas consumption has weakened. From a structural point of view, urban gas and power generation gas have both been greatly affected by the change of oil price, while industrial gas and chemical gas are less affected. The conclusion here will provide an important empirical reference for optimizing the structure of natural gas consumption and maintaining energy security in China. [ABSTRACT FROM AUTHOR]

• Waste plastic film recovery program of Old for New was investigated in northwest China. • Theory of planned behavior (TPB) was extended to explain farmers' participation. • The attitude was as a key factor influencing the intention of recycling behavior. • Plastic film usage & household characteristics evidently affected recycling behavior. • Role of TPB-based compulsory environmental education was highlighted in program. This study aims to address the lack of relevant researches in the field of waste recycling using the Theory of Planned Behavior (TPB). A village-scale social survey was conducted to investigate the degree of farmers' participation in a waste plastic film program, i.e. Old for New in northwest China. The program required farmers to recycle plastic film residues in exchange for new films. Survey results showed that 67.5% of farmers accepted the program, yet only 14.5% of them actually participated. Logistic regression analysis was used to analyze questionnaire data and identify the factors that significantly affected farmers' recycling behavior. Principal component and weight analysis further showed that farmers' participation was mainly influenced by their attitudes (p < 0.01), with a relative weight (RW) of 46.3%. Yet, subjective norms (p < 0.1) and perceived behavior control (p < 0.1) had less effect on the degree of participation, and their RWs were 4.2% and 4.1% only, respectively. Moreover, the RW of plastic film usage characteristics and household characteristics reached up to 13.2% and 6.4%, respectively. Interestingly, environmental awareness (β = 0.083) and compulsory environmental education (β = 0.130) as surface factors strongly affected the farmers' adoption and response, with the RW of 25.7%. As such, the extended TPB model was established to analyze the participation behavior of farmers for stronger explanatory power. This study highlighted a promising strategy based on TPB for waste plastic film recycling and similar environmental management practices. [ABSTRACT FROM AUTHOR]

Isovaleric acidemia (IVA), a rare autosomal recessive disorder in leucine metabolism caused by defected IVD gene, is characterized by episodes of acute metabolic crisis and psychomotor development retardation. This study aimed to determine the clinical, biochemical, and mutation spectrum of patients with IVA from mainland China. Eight patients (three boys and five girls) from eight unrelated families were collected, IVD gene mutations and phenotypes were examined. The patients were admitted because of vomiting, feeding difficulty, psychomotor retardation and "dirty sock" odor. Elevated blood isovaleryl (C5)-carnitine and urine isovalerylglycine were detected from all our patients. Fourteen mutations of the IVD gene were detected, eight of them are novel, c.145C>T (p.Q49Ter), c.359G>A (p.R120Q), c.424C>T (p.R142C), c.458T>C (p.L153P), c.466-1G>T, c.676_677insA (p.T226Nfs*13), c.1039G>A (p.A347T) and c.1076A>G (p.D359G). With this study, a total of 34 alleles were studied in the Chinese population. c.1208A>G (p.Y403C), the common mutation in Taiwan, accounts for 9/34 alleles (7 in previous reports and 2 in this study). We described eight novel mutations detected from eight unrelated Chinese patients and provided evidence to support that the p.Y403C is the hotspot mutation in this population. • Fifteen mutations of the IVD gene were identified from eight Chinese IVA patients. • Eight novel mutations were found. • The mutation p.Y403C is the hotspot mutation in the Han Chinese population. [ABSTRACT FROM AUTHOR]

Background: Obstetrical infection is one of the causes of maternal death and a difficult problem for many clinicians. Changes in the demographic and obstetric background of pregnant women following the Universal Two-Child Policy may have an impact on some fertility phenomena. And with the increase in the number of deliveries, the limited medical resources become more scarce. How will China's health system quickly adapt to the growing needs and expectations for maternal health and ensure the provision of qualified and accessible medical services? In addition, what social support measures should be provided to reduce preventable obstetric complications? Given the relatively low per capita share of medical resources in China, how should China deal with the impact of the Universal Two-Child Policy? Therefore, more studies based on the change of fertility policy are needed. We try to analyze the epidemiological characteristics and risk factors of obstetric infection before and after the Universal Two-Child Policy, with a view to providing reference for the prevention and control of obstetric infection in regions after the change of fertility policy, and also hope to make corresponding contributions to the solution of the above problems through relevant studies.Methods: The subjects of the survey were 268,311 pregnant women from Hebei Province Maternal Near Miss Surveillance System (HBMNMSS) of Hebei Women and Children's Health Center from January 1, 2013 to December 31, 2017. We analyzed the region, time and population distribution characteristics of obstetric infection, compared the epidemiological factors of obstetric infection before and after the Universal Two-Child Policy, and analyzed the relevant risk factors of obstetric infection.Results: The incidence of obstetric infection increased nearly twice after the Universal Two-Child Policy. The incidence of obstetric infection was highest in Chengde (1.9%), a city with a northward geographical distribution, Baoding (1.6%), Cangzhou (1.5%) followed; The higher the hospital grade, the higher the incidence; The incidence of obstetric infections in hospitals at all levels has increased; The age of onset before the Universal Two-Child Policy was (27.82 ± 5.047) years old, and the age after the Universal Two-Child Policy was (28.97 ± 4.880) years old; The incidence of obstetric infections is higher in winter. The rate of abortion-related infection (increased from 0.61 to 1.65%) and the rate of pregnant women with high school education (increased from 0.35 to 0.74%) increased significantly. The results of multivariate Logistic regression analysis after the Universal Two-Child Policy showed that anemia (OR = 1.249, 95%CI: 1.071-1.458), chronic hypertension (OR = 1.934, 95%CI: 1.375-2.722), mild preeclampsia (OR = 2.103, 95%CI: 1.323-3.344) and severe preeclampsia (OR = 2.228, 95%CI: 1.703-2.916) were independent risk factors for obstetric infection. Gestational age ≥ 37 weeks was a protective factor.Conclusion: After the Universal Two-Child Policy, the prevention and control of obstetric infections should be strengthened, especially for abortion-related infections and elderly maternal with obstetric complications and complication in high-grade hospitals in winter. Educational background is also one of the factors that should be considered in the prevention of obstetric sensation. Prolonging gestational age is helpful to reduce the incidence of obstetric infection. [ABSTRACT FROM AUTHOR]

Background: cblC deficiency is the most common type of methylmalonic aciduria in China. Late-onset patients present with various non-specific symptoms and are usually misdiagnosed. The purpose of this study is to investigate the clinical features of patients with late-onset cblC deficiency and explore diagnosis and management strategies around puberty.Results: This study included 56 patients (35 males and 21 females) with late-onset cblC deficiency who were admitted to our clinic between 2002 and September 2021. The diagnosis was confirmed by metabolic and genetic tests. The clinical and biochemical features, disease triggers, outcome, and associated genetic variants were examined. The onset age ranged from 10 to 20 years (median age, 12 years). Fifteen patients (26.8%) presented with symptoms after infection or sports training. Further, 46 patients (82.1%) had neuropsychiatric diseases; 11 patients (19.6%), cardiovascular diseases; and 6 patients (10.7%), pulmonary hypertension. Renal damage was observed in 6 cases (10.7%). Genetic analysis revealed 21 variants of the MMACHC gene in the 56 patients. The top five common variants detected in 112 alleles were c.482G > A (36.6%), c.609G > A (16.1%), c.658_660delAAG (9.8%), c.80A > G (8.0%), and c.567dupT (6.3%). Thirty-nine patients carried the c.482G > A variant. Among 13 patients who exhibited spastic paraplegia as the main manifestation, 11 patients carried c.482G > A variants. Six patients who presented with psychotic disorders and spastic paraplegia had compound heterozygotic c.482G > A and other variants. All the patients showed improvement after metabolic treatment with cobalamin, L-carnitine, and betaine, and 30 school-aged patients returned to school. Two female patients got married and had healthy babies.Conclusions: Patients with late-onset cblC deficiency present with a wide variety of neuropsychiatric symptoms and other presentations, including multiple organ damage. As a result, cb1C deficiency can easily be misdiagnosed as other conditions. Metabolic and genetic studies are important for accurate diagnosis, and metabolic treatment with cobalamin, L-carnitine, and betaine appears to be beneficial. [ABSTRACT FROM AUTHOR]

Background the relationship between low-density lipoprotein cholesterol (LDL-C) and adverse outcomes among the older people remains controversial. Objective to further clarify the association between admission LDL-C levels and cardiovascular mortality (CVM) among oldest old individuals (≥80 years) with acute myocardial infarction (AMI). Design a prospective cohort study. Setting two-centre. Subjects a consecutive sample of 1,224 oldest old individuals with AMI admitted to Beijing FuWai and Shenzhen FuWai hospitals. Methods all individuals were subdivided according to baseline LDL-C levels (<1.8, 1.8–2.6 and ≥ 2.6 mmol/l) and further stratified by high-sensitivity C-reactive protein (hsCRP) concentrations (<10 and ≥10 mg/l). The primary outcome was CVM. The time from admission to the occurrence of CVM or the last follow-up was analysed in Kaplan–Meier and Cox analyses. Results the median age of the overall population was 82 years. During an average of 24.5 months' follow-up, 299 cardiovascular deaths occurred. Kaplan–Meier analysis showed that LDL-C < 1.8 mmol/l group had the highest CVM among oldest old individuals with AMI. Multivariate Cox regression analysis further revealed that compared with those with LDL-C levels <1.8 mmol/l, subjects with LDL-C levels ≥2.6 mmol/l (hazard ratio: 0.67, 95% confidence interval: 0.46–0.98) had significantly lower risk of CVM, especially in those with high hsCRP levels. Moreover, when categorising according to LDL-C and hsCRP together, data showed that individuals with low LDL-C and high hsCRP levels had the highest CVM. Conclusions LDL-C < 1.8 mmol/l was associated with a high CVM after AMI in oldest old individuals, especially when combined with high hsCRP levels, which may need to be confirmed by randomised controlled trials. [ABSTRACT FROM AUTHOR]

Background: Methylmalonic aciduria (MMA), a rare inherited disorder, is the most common organic aciduria in China, and prenatal diagnosis has contributed to its prevention. However, the prenatal diagnosis of MMA using cultured amniocytes or chorionic villi to detect gene mutations is exclusively applicable to families with a definite genetic diagnosis. To evaluate the reliability of mass spectrometry assays for the prenatal diagnosis of MMA, we conducted a retrospective study of our 10 years' experience. Materials and methods: This retrospective compare study reviewed the medical records for maternal and fetuses data for 287 mothers with a family history of MMA from June 2010 to December 2020. Methylmalonate and propionylcarnitine in cell-free amniotic fluid were measured using a stable isotope dilution method (GC/MS) and MS/MS-based method (LC/MS/MS). Total homocysteine (tHcy) was measured by fluorescence polarization immunoassay. Depending on the presence of disease-causing gene mutations in probands, gene studies on amniocytes from 222 pregnant women were performed. Results: For 222 fetuses of the families with definite genetic diagnosis, gene analyses were performed using cultured amniocytes. 52 fetuses were affected by MMA, whereas 170 were "unaffected". For GC/MS and LC/MS/MS, the specificity was 96.5% and 95.9%, sensitivity was 71.2% and 84.6%, respectively. The positive and negative predictive values were 86.0% and 91.6% and 86.3% and 95.3%, respectively. Propionylcarnitine/butyrylcarnitine ratio showed the highest accuracy and could thus serve as a sensitive indicator to identify those at a risk for MMA. When GC/MS and LC/MS/MS were performed in parallel, the specificity was 92.5% and sensitivity was 95.6%. When evaluating tHcy, the positive and negative predictive values were 95.0% and 96.1%, respectively. In 65 fetuses without family genetic diagnosis, 11 were finally confirmed to have MMA and 54 were "unaffected" by amniotic fluid biochemical assays. The 54 children showed normal urine organic acids and healthy development after birth. Conclusions: Amniotic fluid biochemical assays using GC/MS and LC/MS/MS in parallel increased the accuracy of prenatal diagnosis of MMA. Propionylcarnitine is a more reliable marker than methylmalonic acid in amniotic fluid. Further, tHcy is recommended for the prenatal diagnosis of combined MMA and homocysteinemia. [ABSTRACT FROM AUTHOR]

Background Arterial stiffness is related to inflammation, oxidative stress, advanced glycation end products (AGEs), and endothelial dysfunction. Vascular adhesion protein-1 (VAP-1) is both as an adhesion molecule involving in inflammation and as an amine oxidase producing aldehyde and hydrogen peroxide involved in protein cross-linking, oxidative stress and endothelial injury. Objective We explored the associations of plasma soluble VAP-1 (sVAP-1) with arterial stiffness. Design Cross-sectional study. Setting Health Examination Center at the General Hospital of the Air Force in Beijing, China. Subjects 568 Han Chinese healthy persons living in Beijing (aged 50.7 ± 8.0 years). Methods sVAP-1 concentration was assessed by enzyme-linked immunosorbent assay. Arterial stiffness was measured as brachial-ankle pulse wave velocity (baPWV) on both left and right sides of the examinees, and the larger and the mean values were recorded. Cardiovascular risk factors were investigated. Results sVAP-1 was significantly associated with maximal or mean baPWV in subjects of age≥60 years after adjusting for baPWV-related confounders ( β = 36.922, p < 0.05 or β = 32.512, p < 0.05) or after adjusting for all the variables ( β = 37.924, p < 0.05 or β = 33.193, p < 0.05), but not in subjects of age <60 years. sVAP-1 had an independent and positive correlation with age ( r = 0.222, p < 0.001). Conclusions Plasma sVAP-1, increased with age, is associated with arterial stiffness in older individuals. VAP-1 may be important mechanism for vascular aging. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD), the most common chronic respiratory disease worldwide, not only leads to the decline of pulmonary function and quality of life consecutively, but also has become a major economic burden on individuals, families, and society in China. The purpose of this meta-analysis was to explore the risk factors for developing COPD in the Chinese population that resides in China and to provide a theoretical basis for the early prevention of COPD. Methods: A total of 2457 cross-sectional, case-control, and cohort studies published related to risk factors for COPD in China were searched. Based on the inclusion and exclusion criteria, 20 articles were selected. Stata 11.0 was used for meta-analysis. After merging the data, the pooled effect and 95% confidence intervals (CIs) were calculated to assess the association between risk factors and COPD. Heterogeneity between studies was assessed using I2 and Cochran's Q tests. Begg's test was used to assess publication bias. Results: Exposure to particulate matter less than 2.5 μm in diameter (PM2.5) (pooled effect = 1.73; 95%CI: 1.16~2.58; P <0.01), smoking history (pooled effect = 2.58; 95%CI: 2.00~3.32; P <0.01), passive smoking history (pooled effect = 1.39; 95%CI: 1.03~1.87; P = 0.03), male sex(pooled effect = 1.70; 95%CI: 1.31~2.22; P <0.01), body mass index (BMI) <18.5 kg/m2 (pooled effect = 1.73; 95%CI: 1.32~2.25; P <0.01), exposure to biomass burning emissions (pooled effect = 1.65; 95%CI: 1.32~2.06; P <0.01), childhood respiratory infections (pooled effect = 3.44; 95%CI: 1.33~8.90; P = 0.01), residence (pooled effect = 1.24; 95%CI: 1.09~1.42; P <0.01), and a family history of respiratory diseases (pooled effect = 2.04; 95%CI: 1.53~2.71; P <0.01) were risk factors for COPD in the Chinese population. Conclusion: Early prevention of COPD could be accomplished by quitting smoking, reducing exposure to air pollutants and biomass burning emissions, maintaining body mass index between 18.5 kg/m2 and 28 kg/m2, protecting children from respiratory infections, adopting active treatments to children with respiratory diseases, and conducting regular screening for those with family history of respiratory diseases. [ABSTRACT FROM AUTHOR]

Background: Cobalamin C deficiency (cblC) caused by the MMACHC mutations is the most common type of the disorders of intracellular cobalamin metabolism. While the c.609G > A mutation is most frequent in Chinese cblC patients, its correlation with phenotype has not been delineated. Here we aim to investigate the factors affecting variable phenotypes and outcomes associated with the MMACHC c.609G > A homologous mutation in 149 Chinese cases to have implications for treatment and prevention.Methods: We assessed 149 cblC patients caused by MMACHC c.609G > A homozygous mutation. The clinical manifestations, complications, treatment, and outcomes were evaluated; 120 patients were followed-up till December 2019.Results: Two patients (1.3%) were prenatally diagnosed, treated after birth and consequently showed normal development. In 15 patients (10.1%) detected by newborn screening, 10 were treated at the age of 2 weeks and showed normal development, while the other 5 were treated after onset and showed neurologic disorders. All 132 clinically diagnosed patients (88.6%) developed symptoms at age from few minutes after birth to 72 months. Among them, 101 (76.5%) had early-onset (before the age of 12 months) and 31 (23.5%) had late-onset (after the age of 12 months). Totally 5 patients died and 24 were lost to follow-up. Of the 132 clinical diagnosed patients, 92 (69.7%) presented with developmental delay, 65 (49.2%) had seizures, 37 (28.0%) had anemia, 24 (18.2%) had feeding difficulty, 23 (17.4%) had ocular problems, and 22 (16.7%) had hydrocephalus. Compared with the non-developmental delay group, the onset age, the age at treatment initiation and the time from onset to treatment initiation were later in the developmental delay group. Seizure group showed significantly higher urinary methylmalonic acid concentration. During long-term follow-up, plasma total homocysteine (tHcy) levels were significantly higher in patients in the uncontrolled group than those in the seizure-free group.Conclusions: Most cblC patients caused by MMACHC c.609G > A homozygous mutation showed early-onset. The clinically diagnosed patients usually showed the presence of irreversible brain disorders. Patients treated from the pre-symptomatic stage showed favorable outcomes. Therefore, newborn screening, prenatal diagnosis and early treatment are crucial and the c.609G > A mutant allele should be listed in the pre-pregnancy carrier screening panel in China. [ABSTRACT FROM AUTHOR]

Purpose: To assess the safety and efficacy of local intra-gestational sac methotrexate injection followed by dilation and curettage (D&C) in treating cesarean scar pregnancies (CSP).Method: Medical records of CSP patients treated with local intra-gestational sac methotrexate injection followed by dilation and curettage were analyzed at the Maternal and Child Hospital of Guangxi Zhuang Autonomous Region, China.Results: Thirty-one patients were included in this study. The mean gestational age, sac diameter and thickness of the uterine scar were 49.6 ± 7.7 days, 1.8 ± 0.6 cm and 0.30 ± 0.15 cm, respectively. The median pretreatment serum β-human chorionic gonadotropin (β-HCG) level was 40,887 mIU/mL, with the 25th and 75th percentiles at 19,852 and 74,552, respectively. The median blood loss during D&C was 20 mL with the 25th and 75th percentiles at 10 mL and 50 mL. Following D&C, a Foley's balloon catheter compression was implanted in 26 (83.9%) patients due to active uterine bleeding. All patients had a β-HCG regression time of ≤ 4 weeks after D&C. While 30 patients (96.8%) had a uterine recovery time of ≤ 4 weeks, and 29 patients (93.5%) had resumption of menstruation of less than 6 weeks. Three patients (9.7%) had complications. One of them suffered from massive vaginal bleeding and underwent s blood transfusion. There were no other complications, such as pelvic infection and uterine rupture during the procedures. And no patient was converted to surgical resection or uterine artery embolization. Overall, 30 patients (96.8%) were treated successfully.Conclusion: Local intra-gestational sac methotrexate injection followed by D&C with the aid of a Foley's balloon catheter compression appears to be a safe and effective treatment for CSP. Further randomized controlled trials are suggested to confirm these findings. [ABSTRACT FROM AUTHOR]

Acute lung injury (ALI) is a severe disease for which effective drugs are still lacking at present. Forsythia suspensa is a traditional Chinese medicine commonly used to relieve respiratory symptoms in China, but its functional mechanisms remain unclear. Therefore, forsythoside A (FA), the active constituent of F. suspensa , was studied in the present study. Inflammation models of type II alveolar epithelial MLE-12 cells and BALB/c mice stimulated by lipopolysaccharide (LPS) were established to explore the effects of FA on ALI and the underlying mechanisms. We found that FA inhibited the production of monocyte chemoattractant protein-1 (MCP-1/CCL2) in LPS-stimulated MLE-12 cells in a dose-dependent manner. Moreover, FA decreased the adhesion and migration of monocytes to MLE-12 cells. Furthermore, miR-124 expression was upregulated after FA treatment. The luciferase report assay showed that miR-124 mimic reduced the activity of CCL2 in MLE-12 cells. However, the inhibitory effects of FA on CCL2 expression and monocyte adhesion and migration to MLE-12 cells were counteracted by treatment with a miR-124 inhibitor. Critically, FA ameliorated LPS-induced pathological damage, decreased the serum levels of tumor necrosis factor-α and interleukin-6, and inhibited CCL2 secretion and macrophage infiltration in lungs in ALI mice. Meanwhile, administration of miR-124 inhibitor attenuated the protective effects of FA. The present study suggests that FA attenuates LPS-induced adhesion and migration of monocytes to type II alveolar epithelial cells though upregulating miR-124, thereby inhibiting the expression of CCL2. These findings indicate that the potential application of FA is promising and that miR-124 mimics could also be used in the treatment of ALI. • Acute lung injury is a life-threatening disease without effective treatments now. • Forsythia suspense is used to treat pneumonia with its anti-inflammatory activity. • Forsythoside A is a natural product from Forsythia suspense. • Forsythoside A protects mice from lipopolysaccharide-induced acute lung injury. [ABSTRACT FROM AUTHOR]

Background: Human amniotic mesenchymal stem cells (hAMSCs) are being widely applied in various fields. Therefore, hAMSCs represent a promising candidate to facilitate cartilage regeneration. Nonetheless, no studies have investigated the application of hAMSC sheets to repair cartilage defects in vivo. Purpose: To evaluate hAMSC sheets encapsulating cartilage particles to promote repair of rabbit osteochondral defects. Study Design: Controlled laboratory study. Methods: hAMSC sheets were constructed with passage 3 hAMSCs. The phenotypic and structural characteristics of hAMSC sheets were evaluated by flow cytometry and scanning electron microscopy, respectively. The potential for chondrogenic differentiation of hAMSC sheets was assessed by cartilage-specific marker staining, immunohistochemistry, and mRNA and protein expression (SOX9, COLII, and ACAN). Osteochondral defects (diameter, 3.5 mm; depth, 3 mm) were created in the left patellar grooves of 20 New Zealand White rabbits (female or male). The defects were treated with hAMSC sheet/cartilage particles (n = 5), cartilage particles (n = 5), hAMSC sheets (n = 5), or fibrin glue (n = 5). Macroscopic and histological evaluations of the regenerated tissue were conducted after 3 months. The survival time and differentiation of transplanted hAMSCs in the defect area were evaluated by immunofluorescence. Results: hAMSC sheets had a multilayered structure, with cells stacked layer by layer. Importantly, hAMSC sheets highly expressed phenotypic markers of mesenchymal stem cells. Cartilage-specific marker staining and immunohistochemistry were positive, and mRNA and protein expression was higher in the chondrogenically induced hAMSC sheet group than in the hAMSC sheet group (P <.05). hAMSC sheet/cartilage particles formed a large amount of hyaline-like cartilage in the defect area. In addition, macroscopic and histological scores were significantly higher than those in the other groups. Integration with surrounding normal cartilage and subchondral bone regeneration in the hAMSC sheet/cartilage particles group were better when compared with the other groups. A large number of human nuclear-specific antigen-positive cells were observed in the defect area of hAMSC sheet/cartilage particles and hAMSC sheet groups. Moreover, some positive cells expressed SOX9. Conclusion: hAMSC sheets encapsulating cartilage particles facilitate osteochondral defect repair. Clinical Relevance: Delivery of cells in the form of a cell sheet in conjunction with cartilage particles provides a novel approach for cell-based cartilage regeneration. [ABSTRACT FROM AUTHOR]

A phytochemical study on a 70% EtOH extract of dried roots of Polygonum multiflorum resulted in the isolation of four undescribed stilbene glucosides, namely multiflorumisides H K (1 – 4). The structures of the natural products were elucidated by 1D and 2D nuclear magnetic resonance (NMR) as well as mass spectroscopy analyses. Among them, multiflorumiside J (3) and multiflorumiside K (4) belong to rare tetramer stilbene glucosides. Moreover, the in vitro inhibitory activities against protein tyrosine phosphatase 1B (PTP1B) were evaluated and the putative biosynthetic pathway was proposed. Notably, compounds 1 – 4 showed the inhibitory activity against PTP1B with the IC 50 values of 1.2, 1.7, 1.5 and 4.6 μm, respectively. Based on the obtained results, stilbene glucosides could be the potential PTP1B inhibitors of P. multiflorum. Unlabelled Image • Four previously undescribed stilbene glucosides were isolated from P. multiflorum. • Multiflorumiside J (3) and multiflorumiside K (4) belong to rare tetramer stilbene glucosides. • Structures were determined by extensive spectroscopic analyses. • Multiflorumisides H K (1 – 4) exhibited potent PTP1B inhibitory activities. [ABSTRACT FROM AUTHOR]

Background: The statement format of the Decisional Conflict Scale (sf-DCS) is designed and widely used to assess patients' state of uncertainty during health related decision making. As yet no Mandarin version of the sf-DCS has been produced. This study aims to produce the first Mandarin version of the sf-DCS and test its validity and reliability in mainland China.Methods: The translation and cross-cultural adaptation of the original English version of the sf-DCS into Mandarin was carried out in accordance with previously published guidelines. The psychometric properties of sf-DCS were assessed in two hypothesized decision-making contexts through online surveys.Results: In the online survey designed to test scale validity and reliability, 437 people responded to the influenza immunization survey and 238 responded to the breast cancer screening survey. The results confirm that the Mandarin version of sf-DCS has good criteria validity and the exploratory factor analysis suggested a fitted revised five factors model by removing three items. Respondents who were "unsure" about their decisions/intentions, had read less information, and reported lower self-perceived prior knowledge level scored higher on sf-DCS. The Cronbach's alpha for the sf-DCS total score was 0.963 and that for each subscale ranged from 0.784 to 0.937 in both decision making contexts, and the test-retest correlation coefficient was 0.528.Conclusions: The Mandarin version of sf-DCS has good criteria validity and its internal consistency is satisfactory. Our analysis suggests a refinement of the original sf-DCS's factor structure is needed. [ABSTRACT FROM AUTHOR]

In order to investigate the geochemical characteristics, sources and accumulation process of Lower-Jurassic Sangonghe Formation tight sandstone oil, multiple geochemical analyses were performed on source rocks, oil samples and sandstone particles from Wenjisang area in Turpan Basin. The results show that coal-measure source rocks have relatively higher organic matter abundance and type-II organic matter for Xishanyao and Badaowan Formations, with the potential of liquid hydrocarbon generation. Oil samples of Sangonghe Formation have the characteristics of coal-measure-formed oil. Higher maturity indicate the oil may be mainly generated by Lower-Jurassic Badaowan Formation source rocks. Quantitative fluorescence parameters also reflect that hydrocarbons charged into Sangonghe Formation through continuous migration from the bottom of sand body to the top gradually. In down dip direction of Wenjisang area may develope continuous tight oil and gas reservoirs in Lower Jurassic. [ABSTRACT FROM AUTHOR]

Natural gases from the Qiudong and Hongtai gas fields in the Taibei sag in the Turpan-Hami Basin of China were analyzed for stable hydrogen and carbon isotopic characteristics, to investigate the origin of the gas and the gas-source correlation. Natural gases from the two gas fields are dominated by alkane gases with methane content varying from 81.61% to 92.57%. Dryness ranges from 0.76 to 0.93, indicating an abundance of wet gas. The carbon and hydrogen isotopic compositions of the methane vary from − 39.8‰ to − 42.6‰ and from − 263‰ to − 279‰ in the Qiudong gas field, respectively, and from − 37.7‰ to − 39.0‰ and from − 250‰ to − 257‰ in the Hongtai gas field, respectively. All gases have a characteristic carbon and hydrogen isotopic distribution pattern among the C 1 –C 5 alkanes, in which δ 13 C CH 4 < δ 13 C C 2 H 6 < δ 13 C C 3 H 8 < δ 13 C C 4 H 10 < δ 13 C C 5 H 12 and δ 2 H CH 4 < δ 2 H C 2 H 6 < δ 2 H C 3 H 8 . Both the stable carbon and hydrogen isotopic compositions of the gases and the hydrogen isotopic value of the formation water suggest that gases in the two gas fields are coal-derived without admixtures with gases of other origin. According to the calculation with empirical δ 13 C CH 4 –R o % relationship, the thermal maturity (vitrinite reflectance R o %) of the source rocks is up to 0.76% in the Qiudong area and up to 0.86% in the Hongtai area, which are in the oil window and approaching the start of major thermogenesis at the top of the maturity range. Since the gases in the Hongtai gas field are relatively more enriched in 13 C and 2 H, combined with the local geological thermal evolution history, it is concluded that the gases in the two gas fields were derived from the Lower Jurassic Badaowan source rocks. The heavier hydrogen and carbon isotopes of the gases from the Hongtai gas field are interpreted as a product of higher thermal maturity of the source rocks. This is in consistent with the thermal maturity of the local source rocks. The modern thermal maturity of the top of the Badaowan Formation is around 0.8% in the Qiudong area and around 1.0% in the Hongtai area. The combined use of both carbon and hydrogen isotopes is of high value in providing information on gas origin and gas-source correlation, which will be very useful for future gas exploration. [ABSTRACT FROM AUTHOR]

Severe combined immunodeficiency (SCID), a rare type of genetic associated immune disorder, is poorly characterized in mainland China. We retrospectively reviewed 44 patients with SCID who received treatment from 2004 to 2011 in Shanghai, China, and herein summarize their clinical manifestations and immunological and preliminary genetic features. The male-to-female ratio was 10:1. Twenty five patients presented with X-SCID symptoms. Only one patient was diagnosed before the onset of symptoms due to positive family history. The mean time of delay in the diagnosis of X-SCID was 2.69 months (range, 0.5-8.67). Thirty-seven of the 44 patients died by the end of 2011 with the mean age of death being 7.87 months (range, 1.33-31). Six patients received hematopoietic stem cell transplantation (HSCT); only one of them survived, who was transplanted twice. The time between onset and death was shorter in the HSCT-treated group compared with the untreated group (2.87 ± 1.28 and 3.34 ± 0.59 months, respectively), probably due to active infections during transplantation. Bacillus Calmette-Guérin (BCG) complications occurred in 14 of the 34 patients who received BCG vaccination. Transfusion-induced graft-versus-host disease occurred in 5 patients. Total 20 mutations in interleukin-2 receptor subunit gamma ( IL2RG) were identified in 22 patients, including 11 novel mutations. Most patients were misdiagnosed before referred to our SCID Center. Therefore, establishing more diagnostic centers dedicated to the care of PID and accessible by primary immunodeficiency patients will facilitate early, correct diagnosis and better care of SCID in China. [ABSTRACT FROM AUTHOR]

l F. mandshurica has a higher hydraulic efficiency in warm-dry area than cold-wet area. l Vessel density-related traits of ash are lower in warm-dry area than cold-wet area. l Vessel size-related traits positively correlated with temperature in two areas. l Vessel density-related traits in two areas inversely respond to climate change (warming). Xylem anatomical features are constantly adapting to changing environmental conditions, and are directly related to the key functions and physiological processes of trees. However, little is known about the responses of xylem to recent rapid warming in many areas. Based on the anatomical features of the xylem of Fraxinus mandshurica Rupr. from 14 sites in two contrasting areas (warm-dry and cold-wet) of northeast China, the plasticity response and adaptation strategies of radial growth, earlywood vessels (EWV), and hydraulic features of F. mandshurica to climate change were studied. Results showed that, compared with the cold-wet area, F. mandshurica in warm-dry area had wider rings, larger vessel area, higher number of vessels (VN), larger hydraulic diameters (Dh) and higher theoretical tree-ring hydraulic conductivity (Kh). On the contrary, the vessel density (VD), percentage of EWV (PC) and xylem-specific theoretical hydraulic conductivity (Ks) in warm-dry area was lower than those in cold-wet area. In these two areas, the RW, mean vessel area (MVA), total vessel area (TVA), VN, Dh, and Kh were significantly positively correlated with temperature, and negatively correlated with winter moisture. However, the PC, VD, and Ks were inversely related to climate factors in the two areas. F. mandshurica can adjust the density and proportion of EWV by changing the configuration of earlywood and latewood to cope with the interannual climate change and balance the hydraulic efficiency and safety. Rapid warming significantly increased the growing season length and hydraulic efficiency of F. mandshurica in warm-dry and cold-wet areas, thus maximizing carbon fixation. This provides a potential physiological explanation for the growth increase and range expansion of the main broadleaf tree species in temperate zone of northeast China in recent years. F. mandshurica in warm-dry areas benefits greatly from continuous climate warming, but the risk of hydraulic failure may increase. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Infection with high-risk human papillomavirus (hr-HPV) is an important factor associated with cervical cancer. The genetic mutation of HPV16 E6 and integration of HPV16 DNA in the cervical carcinoma tissues are considered important genetic changes in cervical lesion progression. But the studies of hr-HPV epidemiology are relatively less in the area of Sichuan, China. Therefore, we investigated the prevalence of 9 high-risk subtypes and analyzed the genetic mutation characteristic of HPV16 E6 and physical state of HPV16 DNA. Methods: The fragments of L1 and E6 genes were amplified by PCR or nested PCR and then directly sequenced. Further, the multiplex PCR for HPV16 E2 and E6 genes was performed for detection of integration. Results: HPV16, 58 and 18 were prominent, accounting for 78.6%, 20.0% and 9.7%, respectively in 145 isolates. E6 variants revealed that the European (EP) prototype and East Asia (EA) strain were 26 (23.0%) and 34 (30.1%), respectively. Furthermore, there were 14 base substitutions in E6 regions of the study group, of which 12 resulted in amino acid changes and the rest was silent mutation. Significantly, the 240G substitution exactly located the P53 degradation site. Overall, 8 of 114 (7.0%) isolates only contained integrated HPV16 DNA, 43 (37.7%) only contained episomal DNA and 63 (55.3%) contained both integrated and episomal DNA. The proportion of disruption of an intact E2 gene in the patients with cervical cancer is much lower than that in the previous studies. Conclusions: HPV16, 58 and 18 were mainly prevailing subtypes in patients with cervical cancer from Sichuan areas, China and EP/EA strains were predominant in these areas. Some mutations of E6 gene, which lead to the amino acid changes, may be more potentially carcinogenic and the proportion of disruption of an intact E2 gene is much lower. [Copyright &y& Elsevier]

Forest ecosystem conservation practice frequently sacrifices human livelihood, since there exists a structural conflict between both aspects in the degraded forest ecosystem. To reconcile the conflict has been widely viewed as a core issue, in which the payment of ecosystem service (PES) may play a critical role in solving this issue. In order to better understand the practical effectiveness of PES and explore the solution to reconcile the contradiction between conservation and livelihood, we investigated the decadal changes in the Sloping Land Conversion Program as a PES strategy in the Qilian Mountains, a degraded forest ecosystem of northwest China, and its effects on natural and social systems across the 10-year implementation period (2001–2011). The regional NDVI of study site was promoted from 46.24% to 61.28%, showing that vegetation cover had a massive increase during the whole implementation period. Also, the PES strategy had impelled more labor forces as migrant workers into the non-agricultural industries or urban areas. The migration dynamics in three industries demonstrated that the population of primary industry followed a gradually declining trend, and its percentage in total population was lowered from 33.44% to 19.82%. According to our household survey, local farmers reduced the economic investment in agriculture, and this enabled more labor forces to be released from agricultural industry. Interestingly, the attitudes towards the PES program for local inhabitants were gradually shifted from negative at initial stage to acceptable at middle stage, and finally to positive at late stage, as a consequence of PES application. In such case, the PES-led vegetation restoration strategy has been effectively implemented, which can reconcile the contradiction between conservation and livelihood, and ultimately achieve a win-win consequence. Our study provided a successful practical paradigm of coupled human and natural system (CHANS) in forest ecosystem restoration. • We analyzed the dilemma between forest conservation and human livelihood in China. • Sloping Land Conversion Program acted as the Payment for Ecosystem Service (PES). • The PES strategy accelerated the transfer of labors into non-agricultural industries. • Livelihood improvements promoted a fine shift of farmers' attitudes towards PES. • We established a CHANS model to highlight the role of PES in forest conservation. [ABSTRACT FROM AUTHOR]

Simple Summary: Accurate and rapid species identification is crucial in early monitoring and intervention of a pest, especially for a new and emerging pest. Here, the first detailed morphological features of Rhynchaenus maculosus at four life-cycle stages are reported for traditional species identification. Morphology-based identification is not only time-consuming but often inconclusive for closely related sibling species, juveniles, and even not feasible in the absence of key morphological characters. To overcome the limitations of traditional methods in species identification, DNA barcodes (mitochondrial cytochrome C oxidase subunit 1, CO1) were successfully used to identify the pupal and larval specimens as R. maculosus and allocate the undetermined morphospecies in GenBank into their possible taxa. The integration of molecular identification with the morphology-based identification proved to be effective in the accurate and rapid identification of R. maculosus. The oak flea weevil, Rhynchaenusmaculosus Yang et Zhang 1991, is a newly emerging pest that severely damages oak (genus Quercus) in China. The first R. maculosus outbreak occurred in 2020 and caused spectacular damage to all oak forests in Jilin province, northeast China. The lack of key morphological characters complicates the identification of this native pest, especially in larva and pupa stages. This is problematic because quick and accurate species identification is crucial for early monitoring and intervention during outbreaks. Here, we provided the first detailed morphological description of R. maculosus at four life stages. Additionally, we used DNA barcodes from larva and pupa specimens collected from three remote locations for molecular identification. The average pairwise divergence of all sequences in this study was 0.51%, well below the 2% to 3% (K-2-parameter) threshold set for one species. All sample sequences matched the R. maculosus morphospecies (KX657706.1 and KX657707.1), with 99.23% to 100% (sequence identity, E value: 0.00) matching success. The tree based on barcodes placed the specimens into the Rhynchaenus group, and the phylogenetic relationship between 62 sequences (30 samples and 32 from GeneBank) had high congruence with the morphospecies taxa. The traditional DNA barcodes were successfully transformed into quick response codes with larger coding capacity for information storage. The results showed that DNA barcoding is reliable for R. maculosus identification. The integration of molecular and morphology-based methods contributes to accurate species identification of this newly emerging oak pest. [ABSTRACT FROM AUTHOR]